Objective: To discuss the effect of the medical integration mode application in clinical nursing care. Method: Our hospital started to carry out the medical integration mode for inpatients, including joint ward rounds of doctors and nurses, health education and psychological intervention to newly hospitalized, perioperative period, chemotherapy period, discharge patients and so on. Doctors' and patients' satisfaction towards nurses were surveyed. Results: The satisfaction towards nurses was statistically higher than before (P<0.05). Conclusion: Through the application of the medical integration mode, we improved the level of the nurse specialist skills and nursing quality, improved the doctors’ and patients’ satisfaction towards nursing job, built a harmonious medical patient relationship.

Objective: To introduce the experience of Rukang salon on the group intervention for breast cancer patients.Methods: Rukang salon established by Breast Center of Beijing Tiantan hospital is a patient-club for breast cancer patients. Its primary activity was group psychological intervention, combined with volunteer group support. They set up multiple physicianpatient communication platform, including various health education process, peer group activities, web and hotline consultation,to provide continuous, systematic group mental intervention for breast cancer patients. Results: The intervention relieved patients' psychological distress and promoted their posttraumatic growth. Conclusion: The practice of Rukang salon could be used for reference on the design and implementation of group mental intervention.

Objective: To develop and preliminarily verify the psychological intervention program on body image of rehabilitative breast cancer survivors. Methods: Acceptance and Commitment Therapy and group psychological intervention were taken as main theoretical basis to develop the group acceptance and commitment intervention program on body image of rehabilitative breast cancer survivors. To implement the intervention program, rehabilitative breast cancer survivors were investigated by the Body Image after Breast Cancer Questionnaire (BIBCQ), Acceptance and Action Questionnaire (AAQ).Results: The group acceptance and commitment intervention program on body image of rehabilitative breast cancer survivors was formed and enforceable after preliminary verification. Conclusion: The group acceptance and commitment intervention program on body image of rehabilitative breast cancer survivors can be used to help patients to improve their body images in clinic.

Breast cancer as women's common physical and mental health hazard also makes influence on patients' spouses. This article summarized intervention framework theories, approaches, contents, measures evaluation and other aspects of psychological intervention studies for breast cancer patients’ spouses, which designed to provide a certain basis for clinical psychological intervention in breast cancer care.

Psycho-Oncology is a new interdiscipline, covering oncology, social, psychology and ethics. This paper reviewed the development of Psycho-Oncology at home and abroad, pointed out the gap between China and western countries and indicated the direction of future efforts aiming at providing a reference for the development of Psycho-Oncology.

Objective: To evaluate the effect of ADOPT mode on the adjustment level among colostomy patients. Methods:A total of 60 colostomy patients were recruited from 2 tertiary Grade A hospitals in Hengyang, Hunan province by convenience sampling method and were randomly divided into 2 groups with 30 patients in each group. The patients in the control group were given traditional care and the patients in the study group were taken care of using ADOPT mode besides traditional care.Ostomy Adjustment Scale (OAS) was used to evaluate the patients' adjustment level on the first day after surgery, the discharged day, and 4 months after discharge. Results: The scores of OAS and 3 dimensions had significant time main effects in both groups and increased on the discharged day and 4 months after discharge (P<0.05), while the scores of the study group were higher than those in the control group (P<0.05). Conclusion: ADOPT mode could enhance the adjustment level among colostomy patients.

Objective: To explore British nurses' attitudes towards older people, to establish an attitudinal model, and to provide evidence and references for further intervention. Method: Totally 730 certificated nurses who took part in continuing professional education courses in a large university in London, UK were recruited and investigated of the nurses' demographic data, preference to work with older patients, aging knowledge, and attitudes towards older people, et al. Results: Overall 580 effective questionnaires were returned. The variables included in the model could explain 43.6% of the variance of the attitudes,including aging anxiety, attitudes toward healthcare resources allocation among elders, aging knowledge, ethnicity, preference to work with older people, and interaction between education and age. Conclusion: The included variables could explain the variance of the attitude very well. The findings indicate that we should set up intervention guidelines and incorporate aging knowledge into courses of colleges and educational institutes. This study outlines the importance of intervention which has great significance for older people.

Objective: To explore the relationship between professional self-concept and job satisfaction among the HIV/ AIDS department nurses, and to provide the references for improving HIV/AIDS department nurses' professional self-concept and job satisfaction. Methods: A total of 188 nurses working in the HIV/AIDS department from 6 designated AIDS hospitals in Guangdong province were recruited and investigated by Professional Self-Concept of Nurses Instrument (PSCNI) and McCloskey-Mueller Satisfaction Scale (MMSS). Results: The mean scores of professional self-concept and job satisfaction among HIV/AIDS department nurses were (83.36±10.69) and (94.39±15.54), respectively. Job satisfaction has significantly positive relationship with management ability, professional skills, flexibility and degree of satisfaction of professional self-concept(P<0.01) and had no statistical relationship with the communicating skill of professional self-concept. Conclusion: The HIV/AIDS department nurses have positive professional self-concept and a little bit high job satisfaction. Management ability, professional skills, flexibility, and satisfaction of professional self-concept are the influencing factors of job satisfaction. The hospital should cultivate HIV/AIDS department nurse's positive self-concept to improve their job satisfaction, to give play to nurses' enthusiasm and creativity, and to promote the development of HIV/AIDS care.

Objective: To explore the knowledge,attitude and practice(KAP) on avian influenza in community residents and the degree of related knowledge requirements so as to provide references for community nursing intervention. Method: Totally 454 community residents of Fuzhou were surveyed by convenient sampling and investigated the KAP on the avian influenza in community residents. Result: 61.4% community residents had the relevant knowledge on avian influenza; the average score of belief and attitude was 3.91±0.50; the average score of health behavior was 2.87±0.46; The channels that the community residents got the knowledge were mainly through television, radio and newspapers. Conclusion: Knowledge about avian influenza should be promoted, and avian influenza risk factors should be prevented, in order to eliminate the fear of avian influenza.

Objective: To explore the effect of Hospital-Community pressure ulcer management network on preventing bedsore among high-risk elders in communities. Methods: Totally 58 pairs of patients at high risk of pressure ulcers and their family caregivers were randomly divided into the study group and control group with 29 pairs in each group. The control group was given routine treatment and nursing care. The study group was recruited in the Hospital-Community pressure ulcer management network and the caregivers' knowledge about pressure ulcer, skills of position care and daily caring behavior were assessed 3 months after discharge. Results: The caregivers in study group got the higher scores in pressure ulcer knowledge,position care skills and caring behavior than those in the control group (P<0.05). The incidence of pressure ulcer among patients in study group was dramatically lower than that in control group (P<0.05).Conclusions: Hospital-Community pressure ulcer management network could sustain caregivers' knowledge level of pressure ulcer, improve care behavior and decrease the incidence of pressure ulcer among high-risk elders in communities.

Objective: To understand the cognitive status of community nurses' pressure ulcers and to provide the basis for the formulation and implementation of relevant training. Methods: 276 community nurses from 11 community health service center in Pudong district were surveyed by cluster sampling. The questionnaire included the attitude towards pressure ulcers prevention,the knowledge of pressure ulcer prevention and treatment and barriers to pressure ulcers prevention. Results:The mean score of knowledge was 51.20±11.28. Community nurses' attitude on pressure ulcer prevention was overall positive.Lacking of personnel and time, the patients' caregivers' poor coordinating were the three biggest obstacles to prevent pressure ulcers. Conclusion: Community nurses' knowledge of pressure ulcers was not comprehensive.They had positive attitude towards prevention,but there were obstacles preventing pressure ulcers.The new progress in pressure ulcers care was especially lacking,and the practical application of pressure ulcers knowledge existed blindness.The related training was needed to implementing for community nurses to further improve the correct cognition of pressure ulcers prevention, foster positive attitude, allocate human resource rationally and effectively improve the quality of community prevention and treatment of pressure ulcers.

Objective: To reform Nursing Management curriculum and to cultivate practical nursing talents in the secondary vocational nursing education. Methods: The teachers from the school and the clinic integrated Nursing Management course.We added 8 hours of clinical probation courseware and 8 hours of clinical probation. Two classes were randomly divided into the experimental group and the control group. The experimental group was taught according to the integration curriculum of Nursing Management, and the control group was taught according to traditional methods. Result: After the curriculum reform, the satisfaction of teaching effects in the experimental group is higher than the control gruop (P<0.05). The clinical teachers' satisfaction toward the experimental group is higher than the control group (P<0.05). Conclusion: After the curriculum reform, the curriculum could satisfy the students' knowledge demand of adapting clinical work, solve the problem of classroom knowledge integrating with clinical practice, and provide valuable reference for cultivating practical nursing talents.

Objective: To explore the application of Problem-Based Learning (PBL) teaching model in emergency room among nursing undergraduate interns. Methods: Totally 72 nursing undergraduate interns in the emergency room were recruited and randomly divided into control group (n=36) and experimental group (n=36).The control group were taught by Lecture-based learning (LBL) approach, while the experimental group used the PBL teaching method. We compared the theory examination scores and comprehensive examination skills scores of the students in two groups, and investigated the students' recognition to PBL teaching method and their satisfaction. Results: The theory test and comprehensive skills assessment scores among students in the experimental group were significantly better than those in the control group (P<0.05). The students in the experimental group had high subjective recognition and willing to participate in PBL teaching. Conclusion: The application of PBL teaching model in emergency room among nursing undergraduate interns could improve the students' clinical comprehensive ability,motivate their learning interest, and cultivate their autonomous learning ability.

The scenario simulation teaching method set up some kind of realistic work scenarios or management systems which require the learners to complete certain tasks or series of tasks according to certain work requirements in order to train or investigate the abilities and skills of learners. This teaching method could improve the learners' practical abilities and analytical capabilities, therefore it is popularized gradually in Chinese nurses' continuing education. The article reviews the application status of the scenario simulation teaching method in various clinical nursing areas and nursing assessment, describes its application status in Chinese nurses' continuing education, and its further application in the future.

Objective: To implement theoretical practice all-in-one teaching in curriculum integration of medical and surgical nursing and explore the influence of the implementation on educational environment. Methods: The theoretical practice all-in-one teaching method was designed and implemented through the combination of students' autonomous exploration, group discussion and clinical scene learning under the background of curriculum integration of medical and surgical nursing. From teachers and students investigation, education environments of traditional teaching and theoretical practice all-in-one teaching were evaluated.Results: The education environment of theoretical practice all-in-one teaching got high scores from both the teachers and students(3.15±0.13 & 3.04±0.33, respectively). There were significant differences between the new teaching method and the traditional one (P<0.01).Conclusions: Theoretical practice all-in-one teaching could be an effective method in this context of curriculum integration. But it still needed deep exploration on mobilization, professional emotional education, communication skills training and so on.

Objective: To explore the influence of teaching method improvement of specific nursing for tumor patients with radiochemotherapy. Methods: Totally 70 trainees of Grade 2012 in oncology department were selected as observational group, while 67 trainees of Grade 2011 as control group. Both groups accepted one to one teaching based on the clinical pathway teaching method. In the control group, teaching group leader demonstrated the nursing procedure, teachers took charge of the teaching rounds in turn, and nurse students attended the nursing lecture training regularly. In the observational group, a sectional teaching method was used. Four groups of specialty nurses provided lecture, procedure demonstration and teaching effects evaluation consecutively. Nursing students independently hosted teaching round in the later stage of practice. The knowledge and procedure examination results, teaching round quality and students' satisfaction were compared between the two groups. Results:In all three aspects, the observational group was better than control group. Conclusion: The improved method could effectively improve the teaching quality and satisfaction of oncology nursing.

Objective: To introduce of the experience of nursing management organizational reform. Methods: The authors reviewed their hospital nursing management organization reform process from September 2012 to December 2013 based on learning experience from Taiwan. They compared the satisfaction and turn-over rate of nurses before and after the reform.Results: After the nursing management organization reform, nurses' satisfaction improved while their turnover rate decreased,the differences were statistically significant. Conclusions: Restructuring of nursing management organization and involving firstline nursing staff in nursing management could improve the efficiency of nursing management, increase the enthusiasm, sense of identity and belonging to the hospital, and then improve the nursing care quality.

Objective: To calculate the nursing workload of general wards based on measurement of nursing working hours,and use the manpower formula to figure out the numbers of nurses which could meet the clinical needs. Method: Totally 16 typical general wards were selected in a tertiary hospital. From June to August in 2013, well-trained observers were arranged to follow the nurses who were on duty and measure their nursing activities in a one-to-one way. Database was established by EXCEL software. SPSS17.0 was used to calculate the unit average time of direct nursing care. And their corresponding average frequencies per day were calculated by Hospital Information System. Other parameters in manpower formula were calculated in light of the law and absence on leave data from nursing department. Finally numbers of nurses theoretically needed in general wards were calculated when all the parameters' values were determined. Result: The average bed nurse ratio of general wards was 1:0.42 by manpower formula, which was higher than the authorized ratio of 1:0.4 from Ministry of Health. Conclusion:Determination of nurse staffing by nursing workload based on measurement of nursing working hours and Hospital Information System is scientific and rational. Different wards have different nursing workload. Unit characteristics, patient diagnosis, work requirements, and workloads should be considered in order to allocate clinical nurses effectively.

Objective: To explore the effects of implementing Quality Control Circle (QCC) activities to reduce postpartum galactostasis. Methods: The QCC for reducing postpartum galactostasis was set up. The prevalence survey and causal factor analysis were conducted, and then interventions based on the PDCA cycle and the 5W2H principle were implemented. Results:The rate of postpartum galactostasis reduced from 10.4% to 3.2% after the QCC activities. Conclusion: The QCC activities could identify and resolve the important issues in clinical nursing work, reduce the incidence of postpartum galactostasis and increase breastfeeding success rate.

Objective: To explore the effect of applying Quality Control Circle (QCC) on increasing the KAP level of catheter maintenance in patients discharging with PICC. Methods: The QCC team was set up to increase the KAP level of catheter maintenance in patients discharging with PICC. The current status was investigated and some countermeasures based on “5W1H”principles were formulated and implemented after root cause analysis. Results: After the QCC activity, the right response rate of the patients increased from 68.86% to 93.94%, with the total average score rose from (67.87±6.03) to (93.75±3.20). Conclusion:The QCC activity was an effective method to identify and solve problems in nursing. It can increase the KAP level of catheter maintenance in patients discharging with PICC.

Objective: To explore the effect of Root Cause Analysis on the management of burns in acupuncture with warming needle. Methods: We analyzed the reasons of 39 burns in acupuncture with warming needle by Root Cause Analysis,identified the risk factors, found out basic reason, took corrective measures, and compared the effect before and after the implementation of the corrective measures. Results: The incidence of burns reduced significantly after the implementation of corrective measures (P<0.01). Conclusion: Root Cause Analysis and corrective measures are effective for safety management of burn in acupuncture with warming needle and help to reduce the incidence of burn and to improve nursing quality continuously.

In this study, we designed a nursing human resource management system, which included nurses' basic data, data update, data management and data of nurses' transfer. This system can interact with other data systems, and we can get statistical data easily by this system. So this system can improve work efficiency, promote reasonable allocation of nursing human resources and evaluate nurses' performance.

Objective: To explore the accuracy of chemical indicator in pressure steam sterilizing package on monitoring of sterilization effect in sterilization process. Methods: In accordance with the original implementation of Industry Standards of Disinfection and supply Center issued by Ministry of Health on December 1, 2009, we strengthened the management of the whole process of sterilization using the questionnaire survey method, experimental method and random sampling method.We compared the monitoring effect of chemical indicator in sterilization process of different manufacturers commonly used in Chinese hospitals. At the same time, we analyzed the causes of nonconformities,implemented the improvement measures,and improved the package chemical indicator's accuracy of monitoring sterilization effect. Results: The effect of sterilization monitoring were associated with production manufacturer defect, packaging materials with poor permeability, direct contact of chemical indicator with the metal utensils, too large package, too full loading before sterilization, unsatisfactory steam quality,sterilizer operation mistake, and failure operation. Conclusion: The sterilization effects of package chemical indicator were influenced by many factors. The managers should take the initiative to strengthen the sterilization process details management,properly select qualified package chemical indicator according to the different risks level, structure of operation objects, different material, and provide accurate and valuable monitoring results for sterilization package to ensure the quality of sterile objects,medical safety, and a comprehensive high quality nursing service.

Objective: To understand the current status of cancer-related breakthrough pain management (BTP) among medical staff and to provide references for establishing countermeasures and training for medical staff. Methods: Totally 213 oncology doctors and nurses in oncology department were recruited and investigated by a self-designed BTP questionnaire.Result: Most of the doctors and nurses knew well about cancer-related BTP, but there were some weaknesses in the aspects of assessment, treatment, management, health education of the BTP. Conclusion: The hospital managers should enhance the study of BTP knowledge among medical staff and formulating standardized BTP management process to improve effective pain management and quality of life of patients.

Objective: To investigate the knowledge of prevention and management of incontinence-associated dermatitis among clinical nurses. Methods: Totally 330 clinical nurses in Zhenjiang were investigated by a self-designed questionnaire.Results: The score of the knowledge of prevention and management of incontinence-associated dermatitis was lower. Conclusion:Clinical nurses have less knowledge of prevention and management of incontinence-associated dermatitis. It is mostly because of lacking of education related to incontinence-associated dermatitis. It is recommended that knowledge related to prevention and management of incontinence-associated dermatitis should be added in the school education and continuing education. The standard of prevention and management of incontinence-associated dermatitis should be established.

Objective: To learn about current situation of medical waste management in Liaoning province, in order to provide a reference for strengthening the supervision and management. Method: A unified questionnaire was developed according to the medical waste management relevant rules, and then medical waste management current situation was investigated. Result:In 2013, the qualified rate for classified collection of medical waste, use of special packaging or container, handover registration,temporary facilities,conveyance,staff occupational health protection, centralized disposal, and self disposal were 88.3%,85.5%,85.3%,72.8%,61.9%,73.9%,37.1% and 62.9%, respectively. Conclusion: Medical institutions should provide requirements about facilities,equipments and related products for the medical waste disposal, and medical waste management system should be implemented.Relevant departments should strengthen supervision and management and take effective measures to solve the problem of medical waste disposal.

Objective: To investigate the rebuilding and improvement of first-aid and emergency management of medical and health institutionsin Wenchuan earthquake area 5 years later, and to provide references for further reconstruction. Methods:We used convenience sampling method to collect data focused on the emergency facilities, management and personnel training from 18 local hospitals in 5 extreme severe and 13 severe disaster areas in Wenchuan earthquake area. Results: After 5-year reconstruction, emergency facilities in all 18 hospitals have improved greatly, and emergency management and personnel training have improved as well. Conclusion: Post-disaster reconstruction model with Chinese characteristics, particularly in the counterpart cooperation, works efficiently and orderly and plays a great role in post-earthquake reconstruction.

Objective: To evaluate the effects of emergency triage system. Methods: With convenience sampling method,300 patients (100/month) visiting the emergency department in January, April and August 2012 were selected as the control group, and another 300 patients visiting the emergency department in January, April and August 2013 as the experimental group.After adopting the new emergency triage system in experimental group, the waiting time of critical ill patients, the occurrence of unexpected events and the satisfaction of both patients and emergency stuff were compared. Results: The waiting time of critical ill patients in experimental group was shortened significantly, and their satisfaction was higher comparing to the control group (P<0.05). The critical ill patients of the experimental group have no accidents during the waiting time. The medical stuff is quite satisfied with the new triage system. Conclusion: The new triage system is effective to improve the emergency department environment, shorten the waiting time of critical ill patients, reduce the rate of medical accidents and improve the satisfaction of the emergency patients. The medical stuff is satisfied with this new system and it worth spreading in the clinic.

Objective: To ensure the quality and safety of cold medicine. Method: We implemented standardized management of clinical medical refrigerator by using JCI standard. We established a set of systematic, integrated and continuously improving work processes, developed and implemented medical refrigerator management system, medical refrigerator temperature monitoring list, as well as medical refrigerator fault and power failure emergency plan, to manage the 72 medical refrigerators in clinical departments. Result: The temperature control accuracy rate of medical refrigerator increased from 64.33% to 98.71%; the rate of drug classification placement and clear marking increased from 75.06% to 97.75%; nurses' awareness rate of medical refrigerator failure emergency plan was 97.25%. Conclusion: Medical refrigerator management implementation with JCI standard can improve medical staff's awareness of medical refrigerator management, ensure the quality and safety of cold medicine.

Objective: To explore the effects of small group scenario simulation training on enterostomy patients'selfefficacy.Methods: Forty eight patients after enterostomy were divided into five small groups, 8-12 patients in each group. The scenario simulation training scheme included slides speech, multimedia video, group activities and simulation training. The patients' self-efficacy was measured with the Stoma Self-Efficacy Scale after three months. Results: Postoperative patients had middle to high levels of self-efficacy. The scores were higher than that in a domestic cross-sectional survey. Conclusion: The small group scenario simulation training scheme could improve enterostomy patients' self-efficacy in early stage.

Objective: To explore the effect of comprehensive intervention strategies on physical restraint minimization action in SICU. Methods: We developed and implemented comprehensive intervention strategies for physical restraint minimization action in SICU. We assessed the effect of the intervention by the scores of Questionnaire of ICU nurse's knowledge,attitude and practice toward physical restraint, the prevalence of using physical restrict and unplanned extubation rate in SICU before and after nursing intervention. Results: After nursing intervention, the mean scores of the questionnaire was higher than that before the intervention (P<0.05). The prevalence of using physical restrict was significantly decreased (P<0.05), while the unplanned extubation rate did not increase. Conclusion: Comprehensive intervention strategies could enhance SICU staff nurses'knowledge, attitudes and practices toward physical restrict, reduce prevalence of using physical restraint, decrease rates of unplanned extubation,, and achieve the goal of physical restraint minimization action.

This paper analyzes the bottleneck problems of nursing team construction in level two hospitals and proposes the countermeasures to solve the problems, including updating concepts, stabling nursing team; optimizing the knowledge structure,improving nursing professional quality; improving scientific research and innovation management mechanism, enhancing research capacity; establishing competitive mechanism, creating a good atmosphere for the talent growth; adapting nursing professional development, and building clinical nursing service team.

This article summarized overseas and domestic research of measure tools and interventions about diabetes distress in order to provide theory basis for screening and treatment in domestic patients with diabetes distress, to avoid severe mental diseases, and to improve the ability of self-management and quality of life.

Work stress has been a professional risk for nursing assistants in nursing homes. The authors reviewed factors related to their work stress, including health, job satisfaction, burnout and so on. It could provide a reliable basis for the management and team building of nursing assistants in nursing homes.

The CBMD database and CNKI database were searched for published literature on disaster nursing in China.The relevant concepts of disaster nursing and its research progress in China were reviewed, including correlation research on disaster nursing education, nurses' cognitive level, attitude and requirements of disaster nursing and disaster nursing competencies, so as to provide theoretical guidance and reference for further research and development on disaster nursing.

Catheter-associated urinary tract infections have a high incidence among the nosocomial infections. This paper reviewed the risk factors and interventions of catheter-associated urinary tract infection in order to provide reference for hospital managers to take effective and feasible nursing measures and to develop related mechanism and scales.

Objective: To provide a systematic and clear picture regarding midwifery regulations or policies. Method:Historical literature overview methodology was used to identify the progress of midwifery development, and Policy Analysis Triangle was used to identify the factors influencing midwifery policy content and process. Result: History was classified into four stages: ① Origin period(1928-1949); ② Developing period (1949-1979); ③ Vague role period(1979-2008); And ④ Affiliated to nursing period(since 2008). Conclusion: According to the Policy Analysis Triangle and the history of midwifery development in China, we can draw the conclusions that the main influencing factors of the midwifery related policy are the social background and the powers of driving force and now it is the best period to strengthen the midwifery related policy.

With the improvement of people's living standard, the requirement to the quality of life also gradually improved.The studies of patients' sexual life quality after total hysterectomy increased in recent years. The influence on the sexual life quality in patients with hysterectomy was controversial in different studies. Some researchers pointed out that hysterectomy produced severe psychological and mental problems because of severe stress reaction, which ultimately affected the rehabilitation of sexual function and reduced the sexual life quality. While other researchers revealed that total hysterectomy relieved patients'pain and avoided the menstrual discomfort and pregnancy risk, and it was helpful to improve the sexual life quality. At present there were not related studies in this field in China. In this paper, the authors reviewed the influence of total hysterectomy on sexual life quality of patients.